An error-resistant safety culture can only be achieved through proactive clinical risk management. In April 2019 the Federal Joint Committee once again increased the pressure on hospitals by means of the Quality Promotion and Enforcement Directive (QFD Directive) to take measures within the framework of clinical risk management in order to reduce the error and harm rate and therefore to significantly improve patient safety. In the long term this can only be achieved by positively influencing the safety culture and thus the attitudes and motives of all employees. Clinical risk management should focus on the prevention of so-called sentinel events on the one hand and on the reduction of frequent and avoidable complications on the other hand. This not only improves patient safety but also protects employees from negative consequences. Effective clinical risk management always follows a systemic approach, the 10 fields of action of which are discussed in this article. Large meta-analyses have also confirmed the substantial economic benefit of a clinical risk management.
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http://dx.doi.org/10.1007/s00113-019-00740-2 | DOI Listing |
J Ultrasound
January 2025
Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
Introduction: Post-stroke cognitive impairment (PSCI) and dementia affect short- and long-term outcome after stroke and can persist even after recover from a physical handicap. The process underlying PSCI is not yet fully understood. Transcranial Doppler ultrasound (TCD) is a feasible method to investigate cerebrovascular aging or dementia, through the pulsatility index (PI), the cerebrovascular reactivity (e.
View Article and Find Full Text PDFKidney Int
January 2025
Laboratório de Fisiopatologia Renal (LIM 16), Nephrology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil. Electronic address:
In 2017, Kidney Disease: Improving Global Outcomes (KDIGO) published a Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Since then, new lines of evidence have been published related to evaluating disordered mineral metabolism and bone quality and turnover, identifying and inhibiting vascular calcification, targeting vitamin D levels, and regulating parathyroid hormone. For an in-depth consideration of the new insights, in October 2023, KDIGO held a Controversies Conference on CKD-MBD: Progress and Knowledge Gaps Toward Personalizing Care.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
January 2025
Providence Swedish Cancer Institute, Seattle, Washington.
Purpose: Standard therapy for breast cancer after breast-conserving surgery is radiation therapy (RT) plus hormone therapy (HT). For patients with a low-risk of recurrence, there is an interest in deescalating therapy.
Methods And Materials: A retrospective study was carried out for patients treated at the Swedish Cancer Institute from 2000 to 2015, aged 70 years or older, with pT1N0 or pT1NX estrogen receptor-positive and ERBB2-negative unifocal breast cancer without positive surgical margins, high nuclear grade, or lymphovascular invasion.
Psychiatr Pol
October 2024
Śląskie Centrum Chorób Serca w Zabrzu; Katedra i Klinika Kardiochirurgii, Transplantologii, Chirurgii Naczyniowej i Endowaskularnej, Wydział Nauk Medycznych w Zabrzu, SUM w Katowicach.
During qualification for mechanical circulatory support, the comprehensive assessment of a patient's mental state is an integral element of the overall medical evaluation. It encompasses a range of psychosocial issues, and as such provides information helpful in the selection of a suitable candidate for the required treatment, and sometimes identifies contraindications to it. It allows ensuring that the patient meets expectations regarding both mental health stability and adherence to medical recommendations.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto; RISE@Health, Porto, Portugal.
Background: Aortoiliac disease (AID) is a variant of peripheral artery disease involving the infrarenal aorta and iliac arteries. Similar to other arterial diseases, aortoiliac disease obstructs blood flow through narrowed lumens or by embolization of plaques. AID, when symptomatic, may present with a triad of claudication, impotence, and absence of femoral pulses, a triad also referred as Leriche Syndrome (LS).
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